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A few weeks ago, I came across a heart-wrenching clip of a two-year-old child afflicted with malnutrition. Thin to his bones with skin that appeared flaky and straw-like, Roel was not like any other toddler I had ever seen. His eyeballs were nearly scooped out its sockets; his body appeared too fragile, like that of a newborn. At his age, he should’ve been running but he struggled to move and wailed throughout the clip. The child was suffering so bad that watching the video felt like a cross to bear.
Being a mother of a two-year-old boy, the clip hit home. I could feel him struggling to crawl with his elbows. Roel is still unable to talk despite his age and communicates to his parents and eight other siblings through cries of help. “Kung ‘yan ay nakakasalita, masasabi niya sa akin ang totoo [niyang nararamdaman],” his father said. (If only he could talk, then he would be able to say [what he really feels.])
At 24 months, Roel weighs 4.1 kg, roughly a kilo more than my son’s birth weight of 3.4 kg. According to World Health Organization, children of Roel’s age should weigh at least 9.8 kilograms. At 24 months, children of developmentally sound health should already be able to walk, recognize things and people, and speak at least 25 words and coordinate them correctly. Unfortunately, Roel has hit none of these milestones as he is severely malnourished.
Poor provincial life
Roel lives in the remote area of Camarines Sur with his parents, Sonia and Pablo Acunin, and six elder siblings. The matriarch knows only how to weave leaves and this has been her sole way to earn a living. She was only able to finish primary school, and from what I saw, her elder children are following in her footsteps. Roel’s siblings help with their parents’ livelihood and with this, the family earns a meager 100 pesos (two dollars) — an amount that can save one person from hunger, let alone a family with 11 grumbling stomachs. If a family can hardly meet three filling meals a day, how could they ever consider buying the nutritious food they ideally need? Sonia’s family is left with no choice. To get through their hunger, Sonia cooks rice and sinigang na talbos ng kamote (sweet potato tops) with nothing else but a touch of vetsin (monosodium glutamate).
On lucky days, Roel gets his bottle or two of one of the cheapest powered milks available in the market, roughly priced at 10 pesos per pack. The amount of water in his feeding bottle dilutes any hint of milk and is done with the hope of stretching the milks usefulness over a few days. It’s not surprising that the families isn’t thriving in terms of health. With a scarce income, their primary occupation is dealing with how to get through the day without dying of starvation.
Economic cost of malnutrition
Roel isn’t the only one battling severe malnutrition in the nation. In fact, the Philippines leads in the number of malnourished and stunted children in ASEAN countries. Despite the government’s persistent effort in combating malnutrition, it appears that it’s still not enough to eradicate hunger.
One in three children below five years of age is affected by malnutrition. Meanwhile, 26 percent of two-year-old children suffer chronic malnutrition, an all-time-high rate in the last decade. When a child continues to be malnourished for a long time, it leads to childhood stunting — the most common result of under-nutrition that generally affects a child’s overall growth and development.
Childhood stunting has enormous negative effects on the economy. It’s easy to think that it’s only the child who will bear the brunt of these effects but malnutrition and stunting are economic parasites to the entire nation. In 2013, the country lost about 384 billion because of malnutrition and stunting, or about 2.84 percent of the nation’s GDP.
How? First off, education. When a child has been malnourished or stunted in growth, cognitive development is compromised thus resulting in repeating school levels. Based on a report submitted by the Department of Education, some 48,000 students who repeated their grade levels in Academic Year 2013-2014 were a result of stunting at under five years of age. That’s roughly 15 percent of the entire school grade population meaning the government had to cover an additional PhP 1 billion for the children’s education.
Productivity in the workforce is also affected when children are stunted. In 2013, roughly PhP 320 billion was compromised as a result of under-nutrition. This loss of productivity is made up of two classifications: Reduced productivity among stunted workforce and complete loss of productivity due to premature deaths resulting from under-nutrition.
According to a data provided by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST), over 800,000 deaths due to undernutrition weren’t prevented in previous years. If these deaths (of these people who could’ve been of working age) had been averted, the economy could’ve been more productive and generated an additional PhP 160 billion.
Also, undernourished children who manage to overcome the negative health effects will affect economic stability. Studies show that these children are more likely to attain a low education thus translating to fewer job opportunities and reduced income. In 2013, the Philippines lost an estimated PhP 166 billion due to lower educational attainment as a result of childhood undernourishment.
Solution to malnutrition
For Roel’s case, I believe that the solution to his severe malnutrition is breastfeeding. Truthfully, Roel wouldn’t be severely malnourished if he was breastfed. As per World Health Organization’s recommendation, children should be breastfed for at least two years to receive proper nutrition. During the first six months of life, mother-and-child pair should practice exclusive breastfeeding meaning no vitamins, no solids, not even water in the first 180 days of a child’s life.
It’s nearly been two years since I started breastfeeding my son and while the financial burden of buying formula milk is a factor, the very reason I chose to breastfeed my son is because of its health benefits. Scientific consensus states that breastmilk is the superior food for infants and the best supplement when toddlers start eating their solids. Breast milk contains all the nutrients an infant requires, apart from the germ-fighting properties that help fight infection. It’s a perfect food and potent all-in-one medicine and best of all, it’s sterile and free.
When a child reaches six months of age, it’s best to complement the diet with indigenous and nutritious food. The reason it should be indigenous is that it will cater to a child’s health needs. During hot summer days, we can easily attain seasonal fruits such as watermelon or turnips (singkamas) and, amazingly, these fruits are here for a reason: to help in hydration. The same applies to other fruits and vegetables.
The country’s weather is extremely conducive for growing different nutritious whole foods year-round, unlike Western countries. On the other hand, breastfeeding shouldn’t be a problem because only a small percentage of women around the world are clinically unable to breastfeed. In Africa, there are malnourished mothers who are still able to breastfeed despite the lack of food and water. Believe it or not, the nutrients that an African malnourished mother can provide through her breastmilk could equal the nutrients I provide to my son. That’s how functional our bodies can be.
Looking at the roots
Watching Roel with his awful condition begs the question: where does this problem begin? Roel’s family personifies “isang kahig, isang tuka.” From hands to their mouths; they’re living one day at a time. When surviving is tough, how else could they think of thriving?
I cannot blame the family for being poor. Not many of us are lucky enough to be born with a comfortable life waiting ahead. Still, this shouldn’t justify Filipinos’ attitude of complacency — that if we’re born poor, we’re stone-etched destined to die poor.
I believe this kind of problem, like all others, comes from extreme poverty and the lack of education. With proper education, Roel and his family’s life would be a lot easier to bear. Education may not instantly give them a comfortable life but it can enlighten them — awaken their senses that there is more to life than just surviving.
When we become educated, we look at what’s beyond our resources and we think of ways to that can improve our lives. Sadly, education in the Philippines remain not as a right, but a privilege for families like Roel’s.
Had Roel’s parents received proper education, they would have been informed of the consequences of having a big family. Sonia and Pablo were never introduced to the idea of family planning, which lead them to having seven mouths to feed despite their lack of money.
Just enough is fine
The sad reality about some of us is that we have been too complacent to Filipino issues. We choose not to strive for higher heights and instead, settle for something that’s hardly enough. This kind of mindset, unfortunately, gets in the way of improvement and hinders the realization of our goals of important, life changing goals. Like a quicksand, complacency locks us up and when we’re at our most helpless, we give into our unescapable “fate.”
Poverty surely cripples a person but it doesn’t paralyze, unless someone lacks the determination to stand up and brave the odds of breaking through barriers. Roel’s parents, just like the rest of us, are victims of third-world circumstances but that shouldn’t be what defines us in the end.
“I am not a product of my circumstances. I am a product of my decisions.” – Stephen R. Covey